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January 25, 2011

Top Blood Pressure Pill Compares Poorly To Other Treatments

by Sam Savage

In a review of earlier studies, researchers at National Heart, Lung, and Blood Institute (NHLBI) found that the drug, a diuretic, or "water pill," called hydrochlorothiazide, lowered blood pressure by only about half as much as common alternatives such as beta blockers and ACE inhibitors.

This would make the world's most popular blood pressure medicine much less effective than comparable drugs and give patients a false sense of security, the researchers said Monday to Reuters Health.

The drug belongs to an older group of water pills called thiazides, which are sold as generics for a few dollars per month. It is also sold as Aquazide H and HydroDIURIL, among other brand names.

The NHLBI currently recommends thiazides as first-line treatment to rein in high blood pressure, after a large government-funded study failed to find additional benefits from newer, more expensive medicines. The problem is that hydrochlorothiazide, which wasn't tested in that study, remains the go-to water pill, said researcher Dr. Franz Messerli, who heads the hypertension program at St. Luke's-Roosevelt Hospital in New York.

"You cannot just recommend a thiazide as the NHLBI does, knowing that for physicians that translates into hydrochlorothiazide," Messerli told Reuters Health.

According to his report, published in the Journal of the American College of Cardiology, American doctors wrote 134 million prescriptions for the drug in 2008 alone, landing it far ahead of the beta-blocker atenolol, the second-most commonly used blood pressure medicine.

"Hydrochlorothiazide should no longer be used alone," Messerli urged, adding that he has been prescribing it to patients himself for the past 25 years.

High blood pressure affects about a third of U.S. adults, according to the National Heart, Lung, and Blood Institute (NHLBI), and ups the risk of heart attack and stroke when left unchecked. Apart from drug treatment, lifestyle modifications also help rein in blood pressure. Doctors often recommend eating a healthy diet with a low sodium content as well as exercising more and not smoking.